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Plymouth Paediatric Orthopaedics

Anterior Knee Pain

Many teenage girls and to a lesser extent boys experience pain under the kneecap. This is often troublesome for several years but is much less of a problem after the age of 20. The reason for the pain is not always clear although the very high forces generated across the joint between the knee cap and the thigh bone (patello-femoral joint), particularly when squatting, going up or going down stairs, is likely to be contributory.

Around 50% of patients have less pain and have returned to sport 2 years after symptoms start. The pain improves in a further 25% over a slightly longer period, with the remaining 25% unfortunately continuing to have some degree of discomfort.

There is little evidence that any treatment alters the amount or duration of pain. Many patients benefit from quadriceps strengthening exercises with our physiotherapists. If this is not successful, it is usually appropriate to discontinue treatment, in the knowledge that the pain will settle with time.

Occasionally further investigation in the form of x-rays, an MRI scan or even an arthroscopy (keyhole surgery) is indicated, but this is the exception rather than the norm.